Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kippy Macklin

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1881332781

Kippy Macklin is a Nurse Practitioner in Salem, Oregon. Qualified in 2021, 5 years ago. Practices with Fandm Healthcare, LLC, a 29-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon and Washington.

Years since qualifying
5
Licensed in
OR, WA
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

1675 Winter St NE
Salem, OR 97301-7152
Phone: (503) 585-0351
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence AP61298980 (WA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 10020345 (OR)

Record details

NPI number1881332781
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 22, 2022
Last updated in NPPESOctober 22, 2024
Certification dateOctober 22, 2024
Mailing address150 S Wapak Rd, Lima, OH 45807-9404

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Fandm Healthcare, Llc — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Salem